Women's obstacles to sobriety: Isolation, fear, stigma

My latest Addiction and Recovery column

By Bob Gaydos

“I’ve picked up women for meetings and their husbands were on the porch, screaming, ‘Don’t you leave the house tonight! You need to need to be here! Don’t you go with them!’ ”

“Them” would be the women in the car, members of Alcoholics Anonymous picking up a new member to take her to a meeting. This  scenario, described by an Orange County woman who has been sober more than 25 years, illustrates two of the major elements of recovery from addiction for women: 1) the stigma of alcoholism or drug addiction, while lessening, is still greater for women than for men; 2) it is crucial for women new to recovery to have a strong support network of women in recovery.

Women AA members from Orange, Ulster and Sullivan counties confirm what is reported nationally --  as challenging as it is for men trying to recover from the abuse of alcohol or other drugs, in some ways women have it tougher.

Fear. Intimidation. Stigma. Shame. Physical and/or sexual abuse. The debilitating physical effects of alcohol abuse. Some or all of those may be part of the story of that woman in the first paragraph who had the courage to get in the car anyway. To “go with them” to a meeting of Alcoholics Anonymous.

Even then, the challenges persist. Women who have been sober in AA for a while say that one of the biggest issues they faced at the beginning was being able to share at meetings. In AA, sharing one’s story and one’s feelings honestly with other alcoholics is considered important to recovery. “But we’re used to being caregivers,” several women said. “Everybody else’s needs must be more important than mine. Let everybody else (the men) go first and if there’s time at a meeting, I’ll share.”

While more women are seeking recovery today, many AA meetings still have considerably more men than women. “The first meeting I went to was all men and I was intimidated about sharing,” said an Ulster County woman sober for four years.  “So I found meetings where there were women. I went to women’s meetings. We process things differently. We need to have women to talk to. It’s important for women coming in to have other women they can talk to about what’s going on. Sometimes there are things we feel uncomfortable sharing with a lot of men.”

Things like abuse. According to the National Council on Alcoholism and Drug Dependence, in 2008, 70 percent of women who were in drug abuse treatment reported histories of physical and sexual abuse “with victimization beginning before 11 years of age and occurring repeatedly.”

Despite this overwhelming connection between sexual abuse (including incest), domestic violence and substance abuse, the issues are still often treated separately. Advocates for women in recovery urge dealing with them together.

But even when abuse is not an issue, recovery can be more challenging for women. Two Sullivan County women were asked if there is anything more difficult about maintaining recovery for women than for men. “Not really … except that we always have to prove ourselves. You hear in the rooms talk about ‘women of grace and dignity.’ You never hear them say anything like that about men.”

The stigma. In addition to being a challenge to maintaining sobriety, fear and shame often keep women from seeking recovery in the first place. (Will I lose custody of my children? How can my family get along without me? Will I lose my job?)

According to the Center for Substance Abuse Prevention, about 2.7 million women abuse alcohol or other drugs in the United States, the fastest-growing segment of substance abusers in the country. On the positive side, more women are seeking recovery today. Vital to their success, in addition to following whatever program of recovery one chooses and replacing substance abuse with positive behavior, is having other women in recovery with whom to share honestly. To eliminate the feelings of isolation. To remove the shame. To not fear stepping off that porch.

***

Women and alcohol

According to NCADD:

• Women who develop alcoholism have death rates nearly 75 percent higher, than those of male alcoholics. Death from suicide, alcohol-related accidents, heart disease, stroke, cirrhosis of liver, etc. occur more frequently in women vs. men.
• When you compare women and men of the same height, weight and build, men tend to have more muscle and less fat than women.  Because muscle has more water than fat, alcohol is more diluted in a man than in a woman. Therefore, the blood alcohol concentration resulting will be higher in a woman than in a man, and the woman will feel the effects of the alcohol sooner than the man.

A woman’s pattern of drinking is most likely due to one or a combination of factors:

• Having parents, siblings, and/or blood relatives with alcohol problems.

• Having a partner, lover and/or spouse who drinks heavily.
• Having the ability to “hold liquor” (tolerance for) more than others.
• Having a history of anxiety and/or depression.
• Having a history of childhood physical, emotional and/or sexual abuse.

Marty Mann, NCADD’s founder, was the first woman to recover from alcoholism in Alcoholics Anonymous. NCADD is dedicated to increasing public awareness and support for women struggling with addiction to alcohol and drugs. www.ncadd.org

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There's more to recovery than just not drinking

By Bob Gaydos

       

       You’ve heard it plenty of times. Maybe you’ve even said it yourself: “He/she stopped drinking (weeks/months/years) ago, yet he/she is still (pick your own adjective) an angry, irresponsible, lazy, careless, argumentative, moody, selfish, unpleasant person. Sometimes I wish he’d just drink again.”

No you don’t. 

The truth is, although significant advances have been made in understanding the physical and psychological characteristics of alcoholism and drug addiction and considerable improvement has been made in educating the general public about addiction, there remains plenty of confusion about the word “recovery.”

As the first paragraph suggests, it is not simply putting down the drink or the drug. Drinking or drug use are merely symptoms of a complex disease. Simply stopping the use of alcohol or drugs may result in some improvements in a person’s life, but abstinence is not recovery. It’s merely the necessary first step. 

        It’s true that some people can recognize a problem with their drinking, stop before it gets worse and go on to lead what might be considered “normal” lives. But some can’t. These are the ones who may have stopped because of pressure from loved ones, but who continue to behave as they did when they were drinking. They’re referred to as “dry drunks” by people who work in the field, meaning the only thing missing is the drink. 

        That’s what the various recovery programs and 12-step groups are all about -- giving alcoholics or drug addicts a way to live life without the substance and without feeling sorry for themselves. Recovery is not about trying not to drink or drug; it’s about changing the way you live your life.

         It isn’t surprising that the general public might be unclear about what recovery is. Until recently, there wasn’t a generally recognized definition for people who work in the field of substance abuse. In 2007, a panel formed by the Betty Ford Institute to suggest a definition of recovery came up with this: “Recovery from substance dependence is a voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship.” Note the word “voluntarily.”

         A more detailed “working definition” of recovery was presented in May of 2011 by the Substance Abuse and Mental Health Services Administration, which had been working on the question with others in the behavioral health field for several years. SAMSHA’s definition: “Recovery is a process of change whereby individuals work to improve their own health and wellness and to live a meaningful life in a community of their choice while striving to achieve their full potential.”

          Key words: “work;’’ “wellness;” “change;” “choice.”

SAMSHA also issued what it calls guiding principles of recovery. Again, for anyone who suspects he may have a drinking or drug problem, or for anyone who suspects a loved one may have a substance abuse problem, this is a suggested path beyond mere abstinence.

   

SAMSHA’S Principles of Recovery

• Person-driven
• Occurs via many pathways
• Is holistic
• Is supported by peers
• Is supported through relationships
• Is culturally based and influenced
• Is supported by addressing trauma
• Involves individual, family, and community strengths and responsibility
• Is based on respect
• Emerges from hope

SAMSHA also offers four “domains” that support recovery:

• Health: Overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way.
• Home: A stable and safe place to live that supports recovery.
• Purpose: Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors and the independence, income and resources to participate in society.
• Community relationships and social networks that provide support, friendship, love and hope.

       That’s a lot more than, “Hey, I put down the booze, so get off my back.” The professionals agree that recovery is an ongoing process, not a destination. While the journey is different for each individual, it shares common traits: The person has to want to change, not out of resignation to a miserable life without drink, but rather with hope for a more rewarding life, with the support and respect of others.

       Recovery is something to enjoy, not endure.

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